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P00.4 vs P04

P00.4 (Newborn affected by maternal nutritional disorders) compared with P04 (Newborn affected by noxious substances transmitted via placenta or breast milk), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because P00.4 lists P04 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

Title wording and billing status.The titles share “Newborn affected by”; P00.4 says “maternal nutritional disorders” where P04 says “noxious substances transmitted via placenta or breast milk”. P04 is a non-billable header; P00.4 is billable.

Registry fact

Can these codes be reported together?

Yes, when both are documented.P00.4 lists P04 under Excludes2: “newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code.

Official rule

Is there an Excludes2 relationship?

Yes.P00.4’s tabular entry: “newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)”. The note covers P04.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.P04 is a non-billable header, but P00.4 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

P00.4
Newborn affected by maternal nutritional disorders
↔
P04
Newborn affected by noxious substances transmitted via placenta or breast milk

What we found

Yes, when both are documented.P00.4 carries an Excludes2 note covering P04: “newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

P00.4Newborn affected by maternal nutritional disordersP04Newborn affected by noxious substances transmitted via placenta or breast milk
Billing statusBillableNon-billable header

Report instead: P04.0, P04.11, P04.12, P04.13, P04.14

ClassificationP00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96)P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96)
DefinitionNewborn affected by maternal nutritional disorders is a billable ICD-10-CM diagnosis code (P00.4).Newborn affected by noxious substances transmitted via placenta or breast milk is a non-billable ICD-10-CM category code (P04).
Includes
Newborn affected by maternal disorders classifiable to E40-E64
Maternal malnutrition NOS
nonteratogenic effects of substances transmitted via placenta
Excludes2
encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
newborn affected by maternal complications of pregnancy (P01.-)
newborn affected by maternal endocrine and metabolic disorders (P70-P74)
newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)
congenital malformations (Q00-Q99)
encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
neonatal jaundice from excessive hemolysis due to drugs or toxins transmitted from mother (P58.4)
newborn in contact with and (suspected) exposures hazardous to health not transmitted via placenta or breast milk (Z77.-)
Code first
any current condition in newborn
any current condition in newborn, if applicable

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

Edit this comparisonCheck a whole claim

Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources